Women's experiences with tailored use of a combined oral contraceptive: a qualitative study.

STUDY QUESTION: What are women's experiences with tailored use of combined oral contraceptive pills (COCPs)? SUMMARY ANSWER: Some women reported very positive experiences with tailored use of COCPs, others did not like the unpredictability about when they would bleed and some women reported increased anxiety about possible pregnancy. WHAT IS KNOWN ALREADY: While many studies have investigated views toward extended use of COCPs, little research has examined women's actual experiences with these regimens. STUDY DESIGN, SIZE, DURATION: This was a semi-structured qualitative interview study that was part of a larger randomized trial of a standard (21 daily pills followed by a 7-day pill-free interval) versus a tailored regimen (daily pills until 3-consecutive-day bleeding triggers a 3-day pill-free interval) of Microgynon 30® mcg (Ethinyl estradiol 30 mcg, Levonorgestrel 150 mcg). PARTICIPANTS/MATERIALS, SETTINGS,
METHODS: Interviews were conducted with 26 women (17 in the tailored group and 9 who switched their assigned treatment group) . Data were analyzed using thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE: Women discussed positive changes associated with tailored use of COCPs, as well as some negative consequences. The major themes identified in the interview data were: ease of tailored regimen; changes in cycle-related symptoms; adjustment to reduced/absent bleeding and unpredictability about bleeding. LIMITATIONS, REASONS FOR CAUTION: The sample comprised mainly young, nulliparous women. The majority of women were using COCPs at the start of the study. WIDER IMPLICATIONS OF THE
FINDINGS: Clinicians discussing extended-use regimes with patients should mention that women may need time to adjust to an extended-use regime. Future research should attempt to identify predictors of response to extended use of COCPs.